Vital Statistics Form

Please fill this form out as much as possible. It will help us to complete the death certificate and in writing the obituary. All fields with an asterisk are required.

Deceased's Information

If residence, please include address
mm/dd/yyyy
English, Irish, French, German, etc.
Be specific
Primary occupation during working years. *Do not enter \"retired\".
Sales, Medical, Engineering, Construction, etc.
Please list survivors and relationship: son, daughter, brother, sister, etc.
Religious affiliations, fraternal and civic organizations, hobbies, etc.

Informant's Information

A copy of what is submitted will be sent to this email.
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Obituaries & Condolences

Opal Seals

William Dale Hunter

Anthony Francis Ahnemann

David Lowe

R. Scott Firebaugh

Zelma Fare Johnston

Russell “Rusty” Dean Elliott

Ernest Lee Paris

Ellen V. Nasello French

Donald R. Lambeth

Lois Jean Conner

James “Jim” Hodge